Health affairs
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Using data from the Medical Expenditure Panel Surveys for 1997 and 2005, spanning the eight-year period after enactment of the State Children's Health Insurance Program (SCHIP), we examine whether the composition of insurance coverage has changed for working families. Public coverage has played an increasingly important role for working families with children. For families without access to job-based insurance, roughly two-thirds of single-parent and over half of two-parent families with children had at least one family member covered by public insurance in 2005. Among families with access to job-based insurance, nearly half of minority single-parent families had at least one family member with public coverage.
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The Generic Open (GO) License is a proposal to make patents more accessible for vaccines and drugs in low- and middle-income countries. However, for some health-related products, such as vaccines, intellectual property is frequently not the primary constraint. Technical know-how and assurance of a viable market built on reliable demand at prices that cover costs are the most critical factors for vaccine access. Together with innovative efforts to reduce product development risks and costs and to assure credible markets at profitable prices, the GO License may yet play a role in assuring access for drugs and vaccines for poor countries.
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Human papillomavirus (HPV) vaccines hold great promise for preventing cervical cancer, but 93 percent of mortality worldwide occurs in low- and middle-income countries, where high vaccine costs can restrict dissemination. Current models for promoting international access to health care innovations include differential pricing, advance market commitments, and voluntary and compulsory licensing. Some of these mechanisms have been effective, but much room for improvement remains. We discuss the usefulness of a new type of license that uses market forces to lower prices through generic competition in low- and middle-income countries while ensuring that pharmaceutical companies are appropriately reimbursed for their research and development.